| NPI | 1982104675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH EVANS Owner/Dentist 802-309-4431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: VT 016.0094121) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |